Provider Demographics
NPI:1831974674
Name:ROWELL, CAROLINE C
Entity type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:C
Last Name:ROWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:698 KEATS CT
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-3121
Mailing Address - Country:US
Mailing Address - Phone:678-886-2182
Mailing Address - Fax:
Practice Address - Street 1:698 KEATS CT
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-3121
Practice Address - Country:US
Practice Address - Phone:678-886-2182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA267006163WX0200X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No163WX0200XNursing Service ProvidersRegistered NurseOncology